INTERNSHIP APPLICATION PACKET 2022

Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 18 Oxford Place, Madison, WI 53704 Phone: (608) 244-3390 Fax: (608) 244-3901 www.mapleblufffire.com “Serving with pride” Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 INTERNSHIP INFORMATION Internships have always been used as a steppingstone to help individuals get an edge in their chosen career. Our internship program could be your steppingstone. In today's fire service, Emergency Medical Service (EMS) has become an integral part of a firefighter's job requirements. The Maple Bluff Fire Rescue Department offers both fire and EMS experience to our interns. We provide our interns the opportunity to receive EMS certification to the Wisconsin EMT-Intermediate Technician/Advanced EMT Level and the State of Wisconsin Firefighter II Certification while achieving your Associate Degree in Fire Science from Madison Area Technical College. Our intern firefighter/EMTs will also experience the camaraderie of living in a fire station and performing assigned duties as a team. In order to qualify to be an intern with our department you must be enrolled in or on the waiting list for the Fire Protection Program at Madison Area Technical College. If selected, your internship will last for the duration of the associate’s degree program (2 years). Our department offers four trainings per month, three fire and one EMS, to keep our staff trained to today's ever-changing standards. The Maple Bluff Fire Rescue Department provides financial assistance for additional trainings and classes. Our internship is a chance to receive the needed training, experience, and life skills to help you succeed in a career in the fire/EMS service. MAPLE BLUFF FIRE RESCUE DEPARTMENT Maple Bluff Fire Department is a combination department consisting of 4 full-time staff, duty officers, paid-on-call personnel and up to 7 interns. Our apparatus consists of a command SUV, two engines and a boat for lake/water rescues. Our primary response area consists of the Village of Maple Bluff. The Maple Bluff Fire Rescue Department proudly serves its 1400 residents by providing fire suppression, fire prevention, vehicle extrication, public education, fire inspections, water/ice rescue, and emergency medical services. We also respond with neighboring departments when requested through the Mutual Aid Box Alarm System (MABAS) Division 115. Some of our mutual aid partners include the City of Madison, Deforest, Monona, Truax Field (Dane County Regional Airport), Cottage Grove, Marshall, and Waunakee Fire Departments. Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 QUALIFICATIONS AND QUALITIES The Maple Bluff Fire Rescue Department is an equal opportunity organization. QUALIFICATIONS/REQUIREMENTS: • be a United States citizen • be at least 18 years of age prior to starting Madison College’s Associate Degree Program • be a high school graduate or possess a high school equivalency diploma • Enrolled in or on the waiting list for the Fire Science Associate Degree Program at Madison College • possess a valid Wisconsin driver’s license • must be of good mental and physical health • pass a physical agility/written examination • pass a pre-employment medical/drug screening QUALITIES DESIRABLE IN A FIREFIGHTER/EMT: • motivation to serve • effective communication skills • good physical, mental, emotional health • ability to exercise sound judgment • strong sense of responsibility • compassion in all situations • ability to work as team member • honesty and integrity • good problem-solving skills • desire to work hard • sense of humor APPLICATION DEADLINE Internship applications must be received prior to 4:00pm, February 25th, 2022. For an applicant to be considered for the position, the following must be turned in: -Completed Application -Copy of Driver’s License -Copy of Social Security Card -Copy of Birth Certificate Completed materials can be emailed to Assistant Chief Jeff Drager (jdrager@villageofmaplebluff.com) or dropped off at our station located at Maple Bluff Fire Rescue Department, 18 Oxford Place, Madison, WI 53704. INTERVIEWS Internship interviews will be held in March. JOB OFFER Internship candidates who are accepted into the program will be notified prior to April 16th, 2022. Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 APPLICATION FOR MEMBERSHIP (Please Print or Type) Date Application Submitted: ________________ Last Name: __________________________ First Name: ______________________ Middle Initial: ______ Address: ____________________________________________________________ City: _____________________________ State: _________ Zip Code: ___________ Home Phone: (___) _____-_______ Work Phone: (___) ____-_______ Cell Phone: (___) _____-_______ E-Mail: __________________________________________ Cell Service Provider: __________________________ How did you here about us? Friend: ___ Name: ___________________________________ Advertisement: Internet: _____ Flyer: _____ Direct Mailing: _____ School (name):_________________________ Other (describe):________________________ Date of Birth: ____/_____/_____ Social Security Number: ______-_____-______ Driver License Number: ____________________________________ State: _______ Are you at least 18 years old? Yes ____ No ____ Do you have a high school diploma or equivalent Yes ____ No ____ What High School Did You Attend? __________________________________________________ Are you currently enrolled in the Associate of Fire Science Program at MATC? Yes ____ No ____ Are you prevented from lawfully becoming employed? in this country due to visa or immigration status? Yes ____ No ____ If yes explain? ____________________________________________________________________ Have you been convicted of a felony? Yes ____ No ____ If yes explain? ________________________________________________________________________ _____ Maple Bluff Fire Rescue Department www.mapleblufffire.com Phone: 608.244.3390 Fax: 608.244.3901 18 Oxford Place Madison, WI 53704 Current Employer: ___________________________ Dates Employed: _______ to _______ Address: ___________________________________ Phone number: (____) _____ -______ Job Title: _______________________ Supervisor: _________________________________ May we contact your employer? Yes____ No_____ Previous Employer: ___________________________ Dates Employed: ______ to _______ Address: ___________________________________ Phone number: (____) _____ -______ Job Title: _______________________ Supervisor: _________________________________ May we contact your employer? Yes____ No_____ (Attach additional sheets if needed. You need only list your past five years of employment) (Applicants may include a resume, however this is optional) List Any Specialized Training, Certifications, License, or Skills. (first aid, CPR, etc.) _________________________________________________________________________________ ________________________________________________________________ _________________ ______________________________________________________________________________ List Any Previous Fire/EMS Service Experience (not required): Department Name: ___________________________ Years Served: ___________________ Rank/Position: ________________ Supervisors Name: ___________________________ Phone # (____) _____-________ If not selected as an intern, are you interested in volunteering with our department? Yes____ No____ APPLICANT’S STATEMENT I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation/background check through the Police Department, State, FBI, or any other recognized organization. I understand and agree that I may be required to take a physical examina tion as a condition of employment/ membership. In the event of employment/ membership, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer/ membership. ________________________________ __________________ Signature of Applicant Date